EHRs figuring in more malpractice claims, study finds
- As adoption of EHRs by hospitals and physician practices has grown, so has the pace of medical malpractice claims in which EHRs played a role, a new study by The Doctors Company shows.
- While still small overall, EHRs figured in 66 malpractice claims between July 2014 and December 2016, versus just two from 2007 to 2010—the timeframe of an earlier analysis. Diagnosis-related allegations accounted for roughly a third of those claims, up from 27% in the earlier study.
- The study of 66 EHR-related malpractice claims also cast a light on EHR systems, which factored in 50% of the claims, an 8% increase since the original study. System factors include design issues, lack of integration of hospital EHRs and absence or failure of alerts and alarms.
Interoperability is an ongoing issue and a major barrier to the goal of seamless integration of patient information and care coordination across disparate organizations. The federal government’s interoperability roadmap is designed to eliminate obstacles to data sharing and increase the use of recognized interoperability standards, but much remains to be done.
But systems aren’t entirely to blame. User error — such as data entry and copy-and-paste mistakes and alert fatigue — is also a big problem, showing up in 58% of the claims the researchers looked at. Still, this is a 6% improvement over the previous study.
The study also shows more EHR-related claims events occurring in patient rooms and fewer in hospital clinics, doctor offices, ambulatory surgery centers, labor and delivery and emergency rooms.
As for specialties, orthopedics, emergency medicine and obstetrics/gynecology showed increases in numbers of claims, while internal medicine, hospital medicine, cardiology, family medicine and nursing all declined.
EHRs are still evolving and so is user understanding of their capabilities and potential pitfalls, the study suggests.
“While digitization of medicine has improved patient safety, it also has a dark side — as evidenced by the emergence of new kinds of errors,” Robert Wachter, chair of the Department of Medicine at the University of California-San Francisco, said in a statement. “This study makes an important contribution by chronicling actual errors, such as wrong medications selected from an autopick list, and helps point the way to changes ranging from physician education to EHR software design.”
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